Meningitis

Subject: Community Health Nursing II

Overview

An inflammation of the meninges—the membranes that cover your brain and spinal cord—is known as meningitis. The most common cause of meningitis is a viral infection, however bacterial infections can also be to blame. Microbiological meningitis When bacteria enter the bloodstream and travel to the brain and spinal cord, acute bacterial meningitis typically results. Acute bacterial meningitis can be brought on by a variety of bacterial strains. The most prevalent ones are: Haemophilus influenzae, Neisseria meningitides, Streptococcus pneumoniae (pneumococcus), (Haemophilus). Meningitis from a virus The majority of the time, viral meningitis is mild and resolves on its own. iii.Meningitis with fungus Chronic meningitis is brought on by fungus meningitis, which is relatively uncommon. Sometimes it can seem exactly like acute bacterial meningitis. This specific type of meningitis, however, is not communicable. People with immunological weaknesses, such as AIDS, are susceptible to the common fungal type of the disease known as cryptococcal meningitis. If you don't take an antifungal drug to treat it, it could be fatal. Skipping immunizations, becoming older, living in a community, getting pregnant, and having a weakened immune system are risk factors. Blood cultures, imaging X-rays, computerized tomography scans, spinal taps, and lumbar punctures can all be used to diagnose meningitis. The type of meningitis determines how it is treated. Meningitis caused by bacteria To ensure recovery and lower the danger of consequences like brain swelling and convulsions, acute bacterial meningitis requires rapid treatment with intravenous antibiotics and, more recently, corticosteroid medicines. Meningitis from a virus Viral meningitis cannot be cured by antibiotics, and the majority of patients get better on their own in a few weeks. Treatment for viral meningitis in mild cases typically involves: - Bed rest - Lots of fluids - Over-the-counter analgesics to ease body pains and lower fever Treatment of infections like sinusitis, mastoiditis, and ear infections when needed can prevent meningitis. During all intracranial procedures, rigorous aseptic protocols must be used. When making a dressing, strictly adhere to aseptic procedures. antibiotics for prevention following head traumas. If a fever or another indication of meningitis develops, the patient should be closely monitored and evaluated as away.

An inflammation of the meninges—the membranes that cover your brain and spinal cord—is known as meningitis.

Headache, fever, and stiff neck are among the indications and symptoms of meningitis that are frequently brought on by the condition's swelling.

Symptoms:

Any person older than 2 may have the following signs and symptoms:

  • Acutely high fever.
  • A terrible headache that can't be mistaken for another kind of headache.
  • Rigid neck.
  • Nausea or vomiting combined with a headache.
  • Confusion or attention deficit.
  • Seizures.
  • Drowsiness or trouble waking up.
  • Light sensitivity.
  • Lack of desire to consume food and drink.
  • In some situations, such meningococcal meningitis, there may be a skin rash.

Causes:

The most common cause of meningitis is a viral infection, however bacterial infections can also be to blame. A fungus infection can less frequently result in meningitis.

  • Bacterial meningitis
    • When bacteria enter the bloodstream and travel to the brain and spinal cord, acute bacterial meningitis typically results.
    • Acute bacterial meningitis can be brought on by a variety of bacterial strains. The most common include:
      • Streptococcus pneumoniae (pneumococcus).
      • Neisseria meningitides (meningococcus).
      • Haemophilus influenzae (Haemophilus).
  • Viral meningitis:
    • More cases of meningitis are brought on by viruses than by bacteria each year. The majority of the time, viral meningitis is mild and resolves on its own. The majority of viral meningitis infections in the US are caused by a family of viruses called enteroviruses. Acute bacterial meningitis can be brought on by a variety of bacterial strains.
  • Fungal meningitis:
    • Chronic meningitis is brought on by fungus meningitis, which is relatively uncommon. Sometimes it can seem exactly like acute bacterial meningitis. This specific type of meningitis, however, is not communicable. People with immunological weaknesses, such as AIDS, are susceptible to the common fungal type of the disease known as cryptococcal meningitis. If you don't take an antifungal drug to treat it, it could be fatal.

Risk factors:

  • Skipping vaccinations: 
    • The risk of meningitis is higher if you or your child haven't finished the prescribed childhood or adult vaccination schedule.
  • Age: 
    • The majority of viral meningitis cases involve youngsters under the age of five. People under the age of 20 are frequently affected by bacterial meningitis, especially those who reside in communal situations.
  • Living in a community setting: 
    • Meningococcal meningitis is more common among dorm-dwelling college students, military personnel, and kids in boarding schools and daycare centers.
  • Pregnancy: 
    • You are more likely to develop listeriosis, an infection brought on by the listeria bacterium that can also result in meningitis, if you are pregnant.
  • Compromised immune system: 
    • AIDS, alcoholism, diabetes, and use of immunosuppressant medications are some factors that can weaken your immune system and increase your risk of contracting meningitis.

Tests and diagnosis:

  • Blood cultures: 
    • Blood drawn from a vein is sent to a laboratory and placed in a special dish to see if it grows microorganisms, particularly bacteria.
  • Imaging, X-rays and computerized tomography (CT) scans of the head, chest or sinuses may reveal swelling or inflammation.
  • Spinal tap (lumbar puncture): 
    • The definitive diagnosis of meningitis requires an analysis of your cerebrospinal fluid (CSF), which is collected during a procedure known as a spinal tap.

Treatments and drugs:

The treatment depends on the type of meningitis. Like:

  • Bacterial meningitis:
    • To ensure recovery and lower the danger of consequences like brain swelling and convulsions, acute bacterial meningitis requires rapid treatment with intravenous antibiotics and, more recently, corticosteroid medicines.
  • Viral meningitis:
    • Viral meningitis cannot be cured by antibiotics, and the majority of patients get better on their own in a few weeks. In mild cases of viral meningitis, the following steps are typically taken:
      • Bed rest
      • Plenty of fluids
      • Over-the-counter pain medications to help reduce fever and relieve body aches

Prevention:

  • Adequate care for infections such ear infections, mastoiditis, and sinusitis.
  • During all intracranial procedures, rigorous aseptic protocols must be used.
  • When making a dressing, strictly adhere to aseptic procedures.
  • Antibiotics for prevention following head traumas.
  • If a fever or another indication of meningitis appears, you should be closely watched and get checked out right away.

REFERENCE

  • Acharya M & Shirley Croonquiet PCV, 2048 BS, Theory Lecture Outlines, Nursing Care of Children
  • Ambika Rai, Kabita Dahal. Community Health Nursing II. Kathmandu: Makalu Publication House, 2012 (reprint).
  • Dr.Panta SD (Immunization Medical Officer, WHO/IDP) (2005), Training Handout of Immunization
  • HealthLine. 2005. 2017 http://www.healthline.com/health/meningitis
  • KidsHealth. 1995. 2017 http://kidshealth.org/en/parents/meningitis.html
  • Mandal, G.N. Textbook of Adult Nursing. Kathmandu: Makalu Publication House, 2013.
  • Textbook of Adult Nursing for PCL Nursing Student, reprint 2008, 1st edition HLMC
  • Web MD. 2005. 2017 http://www.webmd.com/children/understanding-meningitis-basics#1

 
Things to remember
  • Meningitis is an inflammation of the membranes (meninges) surrounding your brain and spinal cord.
  • Meningitis usually results from a viral infection, but the cause may also be a bacterial infection.

i.Bacterial meningitis

ii. Viral meningitis

iii. Fungal meningitis

  • A risk factor is: skipping vaccinations, age, living in a community setting, pregnancy, and compromised immune system.
  • Meningitis can be diagnosed by blood cultures, imaging X-rays and computerized tomography scan and spinal tap or lumbar puncture

  • Treatment depends on the type of meningitis.

    i.Bacterial meningitis

    Acute bacterial meningitis requires prompt treatment with intravenous antibiotics and, more recently, cortisone medications, to ensure recovery and reduce the risk of complications, such as brain swelling and seizures.

    ii.Viral meningitis

    Antibiotics can't cure viral meningitis, and most cases improve on their own in several weeks. Treatment of mild cases of viral meningitis usually includes:

    - Bed rest

    - Plenty of fluids

    - Over-the-counter pain medications to help reduce fever and relieve body aches

     

    Prevention of meningitis are:

    _ Adequate treatment of infection such as sinusitis, mastoiditis, and ear infection.

    _ Use of strict aseptic techniques during all intracranial operations.

    _ Use strict aseptic techniques while doing dressing.

    _ prophylaxis antibiotics after head injuries.

    _ closely observed and immediately examined if Fever or other sign and symptom of meningitis develop.

     

Questions and Answers

Meningitis is an inflammation of the membranes (meninges) surrounding your brain and spinal cord.

Meningitis is caused by:

Meningitis is typically caused by a viral infection, but it can also be caused by a bacterial infection. A fungal infection may cause meningitis in rare cases.

Bactericidal meningitis

Bacteria enter the bloodstream and migrate to the brain and spinal cord, causing acute bacterial meningitis.

A variety of bacteria strains can cause acute bacterial meningitis. The most common are:

  • Streptococcus pneumoniae (pneumococcus).
  • Meningitis caused by Neisseria meningitides (meningococcus).
  • Haemophilus influenzae (Haemophilus).

Viral meningitis

Viruses cause more cases of meningitis than bacteria do each year. Viral meningitis is typically mild and resolves on its own. The majority of viral meningitis cases in the United States are caused by a group of viruses known as enteroviruses.

Meningitis caused by fungus

Fungal meningitis is a rare condition that causes chronic meningitis. It can occasionally mimic acute bacterial meningitis. This type of meningitis, however, is not contagious from person to person. Cryptococcal meningitis is a common fungal form of the disease that affects people with compromised immune systems, such as those with AIDS. If not treated with an antifungal medication, it can be fatal.

Signs and symptoms that may occur in anyone over the age of two include:

  • Excessive fever
  • Severe headache that is not easily confused with other types of headache
  •  A stiff neck
  •  Vomiting or nausea with a headache
  • Confusion or difficulty concentrating
  •  Seizures
  •  Drowsiness or difficulty waking up
  • Photosensitivity
  •  Disinterest in drinking and eating
  •  Skin rash in some cases, such as meningococcal meningitis

 

Risk elements

  • Ignoring vaccinations. The risk of meningitis is increased if you or your child have not completed the recommended childhood or adult vaccination schedule.
  • Age. The majority of viral meningitis cases occur in children under the age of five. Bacterial meningitis is most common in people under the age of 20, particularly those who live in communities.
  • Living in a neighborhood. Meningococcal meningitis is more common among college students living in dorms, military personnel on bases, and children in boarding schools and child care facilities.
  • Maternity. If you're pregnant, you're more likely to get listeriosis, an infection caused by listeria bacteria that can lead to meningitis.
  • Immune system dysfunction. AIDS, alcoholism, diabetes, and the use of immunosuppressive drugs can all weaken your immune system and make you more susceptible to meningitis.

Diagnostic tests and procedures

  • Blood tests. Blood is drawn from a vein and placed in a special dish to see if it grows microorganisms, particularly bacteria.
  • Visualization. Swelling or inflammation of the head, chest, or sinuses may be revealed by X-rays or computerized tomography (CT) scans.
  • Spinal Tap (lumbar puncture). The analysis of your cerebrospinal fluid (CSF), which is collected during a spinal tap procedure, is required for a definitive diagnosis of meningitis.

 

Drugs and treatments

The type of meningitis determines the treatment. Like;

Bactericidal meningitis

To ensure recovery and reduce the risk of complications such as brain swelling and seizures, acute bacterial meningitis requires prompt treatment with intravenous antibiotics and, more recently, cortisone medications.

Viral meningitis

Antibiotics cannot treat viral meningitis, and most cases resolve on their own after a few weeks. Mild cases of viral meningitis are usually treated with:

  • Rest in bed
  •  Drink plenty of fluids
  • Over-the-counter pain relievers to help reduce fever and body aches

Prevention

  • Adequate infection treatment, such as sinusitis, mastoiditis, and ear infection.
  • All intracranial procedures must be performed using strict aseptic techniques.
  • When dressing, use strict aseptic techniques.
  • Antibiotics for prophylaxis after head injuries
  • If a fever or other sign and symptom of meningitis develops, the patient should be closely monitored and examined right away.

 

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